HomeMy WebLinkAbout3119 San Luis St - Applications/Solar - 12/05/2017Planning, Development and Transportation
Building Services Department
281 N College Ave P O Box 580
nS Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134 r
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SOLAR PERMIT APPLICATION FORM
This application is to be used to apply for the following permits only (check the appropriate box):
13 Photovoltaic Solar (PV)
❑ Thermal Solar (Hot Water System)
Complete all applicable information on the application. Incomplete applications will not be accepted.
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Application # 01%137-1 Date -+rX17' 0
For office use only i
Job Site Address (required)
Value of Construction (labor, materials, profit)
3119 San Luis St Fort Collins CO 80525
10,640.00
Property Owner Name
Address
City/State Zip
Phone
Calvin Souders
3119 San Luis St
Fort Collins CO 8 0525
9702328309
Applicant Name f
Address
City/State Zip
Phone
CAM Solar I
3443 S Galena St #170 Denver, CO 80231
720-729-8777
Solar Contractor License #/Co Name
Address
City/State Zip
Phone
CAM Solar EC101011 I
3443 S Galena St #170, _ Denver, CO 80231
720-729`8777
Contractor City of R. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here Q Report
Sales tax number is required by al/ contractors
Are you paying with your trust account?
❑ Yes ®' No
I F SOLAR PV SYSTEM, HAS THE PROJECT BEEN PRE -APPROVED BY Cl TY U GHT AND POWER? 0 Yes
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ®Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or morel ❑ Yes R No Ifyes, you may need to contact Historic Preservation
0 No
Description of work'
5.32 kW interactive flushirooftop PV installation of 19 panels
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Please note in description if, roof flush mounted, roof mounted & elevated, ground array, kw amount, how many solar panels
Subcontractors: List the company name or Oty of R Coffins License # (PV MUST list Oty Registered 6eotrictan — Thermal MUST
list Oty Registered Ptl tuber)
Electrioan CAM Solar I Plumber Roofer (For solar PV shingles)
I hereby acknowledge that I have read this application and state that the above information is complete and correct I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not valid untll It has been paid and Issued.
Printl Name Jon Carlson Signature Date 12/5/17
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